Enhanced radiological detection of a corticotroph adenoma following treatment with osilodrostat
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
In approximately 30% of patients with Cushing disease, pituitary magnetic resonance imaging (MRI) does not reliably identify a corticotroph adenoma. Importantly, surgical remission rates are >2.5 fold higher for microadenomas that are radiologically visible on preoperative imaging when compared with “MRI-negative” cases. We describe a 42-year-old woman with Cushing disease, in whom MRI findings at presentation were equivocal with no clear adenoma visualized. She was initially treated with metyrapone, which resulted in partial biochemical control of hypercortisolism. After switching to osilodrostat, there was a marked improvement in her symptoms and rapid normalization of cortisol levels. Following 3 months of eucortisolemia, [11C]methionine positron emission tomography (MET-PET) coregistered with volumetric MRI (MET-PET/MRCR) localized the site of the corticotroph tumor and the patient underwent successful transsphenoidal resection. She remains in full clinical and biochemical remission at >2 years postsurgery. This case suggests that a period of eucortisolemia induced by osilodrostat may facilitate localization of corticotroph microadenomas using functional (PET) imaging.
Date Issued
2025-11-01
Date Acceptance
2025-10-01
Citation
JCEM Case Reports, 2025, 3 (11)
ISSN
2755-1520
Publisher
Oxford University Press
Journal / Book Title
JCEM Case Reports
Volume
3
Issue
11
Copyright Statement
© The Author(s) 2025. Published by Oxford University Press on behalf of the Endocrine Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. See the journal About page for add itional terms
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/41064661
PII: luaf200
Subjects
Cushing disease
[11C]methionine PET
corticotroph adenoma
osilodrostat
Publication Status
Published
Coverage Spatial
England
Article Number
luaf200
Date Publish Online
2025-10-07